NIC 2008 Presented by: Rebecca Coyle Idaho Immunization Program Immunization Information Systems Methods to Evaluate and Improve Data Quality NIC 2008 Presented by: Rebecca Coyle Idaho Immunization Program

Immunization Reminder Information System (IRIS) Overview Idaho has 1.4 million residents Idaho is an opt-in, birth to death registry 87% (284/326) of VFC providers statewide are enrolled in IRIS 75 % of providers submitted data in 2006 As of March 1, 2008 366,982 patients in registry 4.8 million vaccinations ~90 +% of newborns are consented at birth

Provider Data Quality Background In 2006 there were concerns from outside users (providers/stakeholders) about data quality in IRIS Perception was the data quality errors in IRIS = 75% For the first time IRIS would be requesting funding from the State Legislature During the legislative session there would be questions about the accuracy and validity of IRIS data

Provider Data Quality Background To answer the questions that might be asked the IIP Conducted a state-wide assessment in 2006-2007 The error rate was lower than previously believed, but there was a need to increase data awareness among users The IIP conducted IRIS data quality reviews in conjunction with Quality Assurance Review (QAR-AFIX) site visits with 37 providers throughout the state in 2007

Provider Data Quality 2008 The IIP demonstrated a need to increase private provider knowledge of data quality based upon the site visits conducted in 2007 Beginning in 2008 the IIP is conducting IRIS Visits with all enrolled VFC providers A statistically significant sample of VFC providers was pulled for 2008 to receive visits Providers will be placed on a rotation schedule to receive visits in the future

Provider Data Quality 2008 – IRIS Visits Provider patient data is exported from IRIS for all 19-35 month children and imported into Co-CASA Diagnostic & Missing Immunization reports from Co-CASA are generated for the provider Reports are generated from IRIS for data quality and submission details

2007 IRIS Data Quality Reviews Reports used: IRIS Data Quality by IRMS and Facility Report Vaccination Data Quality Report (also Detail report if needed) Provider Submission Detail Report VACMAN Vaccine Accountability Report CoCASA 4:3:1 4:3:1:3:3 4:3:1:3:3:1 Missing Immunizations Report

Provider Data Quality 2008 – IRIS Visits 30 patient charts are pulled for the visit and compared to data in IRIS Patients IRIS records and charts are examined for accuracy Patient records in IRIS that need to be updated are documented and reported on IIP forms Reporting forms help track the data quality visit and training needs Providers are requested to update the missing/different information in IRIS/charts within 30 days of the site visit IRIS reports assist in determining issues with scheduling, vaccine type and empty data fields

Provider Data Quality 2008 – IRIS Visits In addition to discussing data quality the following items are also discussed at the visit Provider resources (located on the IRIS web site) How to do the following in IRIS MOGE (move or gone elsewhere) patients Multi-shot shortcuts Utilize the forecasting options

2008 Data Base Data Quality - Scripts The IRIS Helpdesk is running scripts monthly to find gaps in data quality Scripts include: Infrequently used/no longer licensed vaccines List of vaccinations where 2 shots administered on the same day and 1 does not match vaccine used in Idaho Incorrect dates (off by 1 day)-list of dates not auto-resolved Shot Type-Administered vaccinations that are not used in Idaho

2008 Data Base Data Quality - Scripts Combination vaccines-Combination vaccination also recorded as separate antigens for the same day Unspecified Vaccinations- Specified vaccinations that conflict with others in vaccine family Currently creating plan for addressing issues in scripts

Results We are finishing up the 1st quarter of visits Providers are responding positively to IRIS site visits Allows the IIP to assess provider training needs Increases provider knowledge of IRIS and immunizations, including vaccine documentation Several of the issues discovered have resulted in practice changes Hope to see an increase in data quality & Immunization rates

https://iris.idaho.gov iip@dhw.idaho.gov (208) 334-5931 Questions? https://iris.idaho.gov iip@dhw.idaho.gov (208) 334-5931